Community Paramedicine for Long-Term Care Patients: Examining Clinical Conditions Manageable by Paramedics, Avoiding Emergency Department Visits

Abstract

Background: Long-term care (LTC) patients have high needs for care and are at increased risk when transferred to the emergency department (ED). Objective: This thesis evaluates how paramedics can provide enhanced care to LTC patients, avoiding ED visits. Methods: We completed a systematic review, a national survey, and a health records review. We systematically reviewed existing programs in LTCs seeking to avoid ED visits, assessed program needs through surveying paramedic services, and determined what conditions could be treated by paramedics at the LTC, with a health records review. Results: We found programs reducing ED visits and hospitalizations from LTC patients. Few paramedic services have such community paramedic programs; most would welcome them. Community paramedics could treat 11% of LTC patients on-site, avoiding an ED visit, within current emergency paramedics medical directives. Conclusion: Community paramedics can reduce ED visits and hospitalizations from LTC patients. However, there are barriers to program implementation.